PM&R最新文献

{"title":"Frequency of depression and anxiety symptoms among adults with childhood- versus adult-onset disability.","authors":"Cristina A Sarmiento, Anna Furniss, Megan A Morris, Michelle L Stransky, Darcy A Thompson","doi":"10.1002/pmrj.13333","DOIUrl":"https://doi.org/10.1002/pmrj.13333","url":null,"abstract":"<p><strong>Background: </strong>Individuals with disabilities experience high rates of depression and anxiety. Potential differences between those with childhood- versus adult-onset disability have not been adequately explored.</p><p><strong>Objective: </strong>To examine the relationship between age of disability onset and frequency of reported depression and anxiety symptoms.</p><p><strong>Design: </strong>Secondary data analysis.</p><p><strong>Setting: </strong>2020-2021 National Health Interview Survey (NHIS), a nationally representative survey of adults on illness and disability in the United States.</p><p><strong>Participants: </strong>NHIS respondents aged 22-80 years with mobility, cognitive, or mobility + cognitive disability (n = 6386).</p><p><strong>Interventions: </strong>Age of disability onset (childhood onset, defined as onset before age 22, per NHIS question, vs. adult onset) was our independent variable.</p><p><strong>Main outcome measures: </strong>We calculated frequency of reported current depression and anxiety symptoms among those with childhood- versus adult-onset disability. Logistic regression was used to calculate the odds ratios (OR) of frequent versus infrequent depression and anxiety symptoms for childhood- versus adult-onset disability, adjusted for demographic factors.</p><p><strong>Results: </strong>A higher percentage of participants with childhood- compared to adult-onset disability reported frequent depression symptoms (mobility: 32.7% vs. 21.9%, p < .01; cognitive: 55.6% vs. 44.5%, p < .01; mobility + cognitive: 71.4% vs. 52.8%, p < .01) and anxiety symptoms (mobility: 44.3% vs. 35.5%, p < .01; cognitive: 83.5% vs. 63.1%, p < .01; mobility + cognitive: 82.8% vs. 70.3%, p < .01). Participants with childhood-onset disability had higher adjusted odds of frequent depression symptoms for all disability types (mobility adjusted odds ratio [aOR], 1.58 [95% confidence interval (CI), 1.15-2.16]; cognitive aOR, 1.84 [95% CI, 1.12-3.02]; mobility + cognitive aOR, 2.06 [95% CI, 1.16-3.67]), and frequent anxiety symptoms for cognitive (aOR, 3.28 [95% CI, 1.92-5.60]) and mobility + cognitive disabilities (aOR, 2.01 [95% CI, 1.07-3.75]) compared to those with adult-onset disability.</p><p><strong>Conclusion: </strong>Individuals with childhood-onset disabilities may be at uniquely higher risk for mental health symptoms than their peers with adult-onset disabilities, warranting specific attention to their health care and outcomes.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Etiological factors and clinical outcomes in extracapsular and intracapsular hip fractures among older adults: A gender-specific analysis.","authors":"Radcliffe Lisk, Keefai Yeong, David Fluck, Jonathan Robin, Christopher H Fry, Thang S Han","doi":"10.1002/pmrj.13326","DOIUrl":"https://doi.org/10.1002/pmrj.13326","url":null,"abstract":"<p><strong>Background: </strong>Compared to patients with intracapsular fractures (ICFs), those with extracapsular fractures (ECFs) had worse outcomes. However, most studies of risk factors for these fractures lacked relevant potential reasons, particularly nutritional status, and adjustment for confounding factors. Furthermore, less is known about their effects on clinical outcomes.</p><p><strong>Objective: </strong>To conduct a gender-specific analysis of community-dwelling individuals admitted with hip fractures to examine the association of clinical risk factors and health care measures.</p><p><strong>Design: </strong>Monocentric cross-sectional study.</p><p><strong>Setting: </strong>Orthopedic trauma department.</p><p><strong>Participants: </strong>A total of 787 women and 318 men of similar mean age (±SD): 83.1 years (±8.6) and 82.5 years (±9.0), respectively.</p><p><strong>Main outcome measures: </strong>Multivariable logistic regression analyzed risk factors including age, gender, dementia, stroke, ischemic heart disease, diabetes, prefracture mobility, alcohol consumption, American Society of Anesthesiologists grades, drug history, and nutrition status for assessing risk factors and outcomes associated with ECFs and ICFs.</p><p><strong>Results: </strong>Compared to ICFs, for each additional year of age, women had a 3% and men 4% greater association with ECFs. Among women only, ECFs were associated with risk of malnutrition: odds ratio [OR] = 1.70 (95% CI, 1.17-2.48) or malnourishment: OR = 1.93 (95% CI, 1.06-3.52), stroke: OR = 1.85 (95% CI, 1.16-2.97), and diabetes: OR = 1.92 (95% CI, 1.21-3.06). Women with ECFs were less likely to be discharged to their own homes: OR = 0.56 (95% CI, 0.38-0.83); but more likely to be discharged to a rehabilitation unit: OR = 1.81 (95% CI, 1.21-2.71) and readmitted to hospital within 30 days of discharge ≥1 time: OR: 2.39 (95% CI, 1.27-4.50) or ≥2 times: OR = 3.48 (95% CI, 1.05-11.57): they did not differ in discharge to residential or nursing care or in-hospital mortality. Among men, there were no differences in discharge destinations or readmissions between types of fractures.</p><p><strong>Conclusions: </strong>Compared to ICFs, a greater number of risk factors associated with ECFs were identified more often in women than in men, and ECFs also have greater influences on clinical outcomes in women.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combining procedural and behavioral treatments for chronic low back pain: A pilot feasibility randomized controlled trial.","authors":"Adrienne D Tanus, Isuta Nishio, Rhonda Williams, Janna Friedly, Bosco Soares, Derek Anderson, Jennifer Bambara, Timothy Dawson, Amy Hsu, Peggy Y Kim, Daniel Krashin, Larissa Del Piero, Anna Korpak, Andrew Timmons, Pradeep Suri","doi":"10.1002/pmrj.13323","DOIUrl":"10.1002/pmrj.13323","url":null,"abstract":"<p><strong>Background: </strong>Individual treatments for chronic low back pain (CLBP) have small magnitude effects. Combining different types of treatments may produce larger effects.</p><p><strong>Objective: </strong>To (1) assess feasibility of conducting a factorial randomized controlled trial of these treatments; and (2) estimate individual and combined treatment effects of (a) lumbar radiofrequency ablation (LRFA) of the dorsal ramus medial branch nerves (vs. a simulated LRFA control procedure) and (b) Activity Tracker-Informed Video-Enabled Cognitive Behavioral Therapy program for CLBP (AcTIVE-CBT) (vs. an educational control treatment) on back-related disability at 3 months post-randomization.</p><p><strong>Methods: </strong>Participants (n = 13) were randomized in a 1:1:1:1 ratio in a 2 × 2 factorial randomized controlled trial. Feasibility goals included an enrollment proportion ≥ 30%, a randomization proportion ≥ 80%, and a ≥ 80% proportion of randomized participants completing the 3-month Roland-Morris Disability Questionnaire (RMDQ) primary outcome end point. An intent-to-treat analysis was used.</p><p><strong>Results: </strong>The enrollment proportion was 62%, the randomization proportion was 81%, and all randomized participants completed the primary outcome. Though not statistically significant, there was a beneficial, moderate-magnitude effect of LRFA versus control on 3-month RMDQ (-3.25 RMDQ points [95% confidence interval [CI], -10.18 to 3.67]). There was a significant, beneficial, large-magnitude effect of AcTIVE-CBT versus control (-6.29 [95% CI, -10.97 to -1.60]). Though not statistically significant, there was a beneficial, large effect of LRFA+AcTIVE-CBT versus control (-8.37 [95% CI: -21.47, 4.74]).</p><p><strong>Conclusion: </strong>We conclude that it is feasible to conduct a randomized controlled trial combining procedural and behavioral treatments for CLBP.</p><p><strong>Clinicaltrials: </strong>gov Registration: https://clinicaltrials.gov/ct2/show/NCT03520387.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful treatment of chronic medial plantar nerve entrapment syndrome with hypertrophy of the abductor hallucis muscle using botulinum toxin injection.","authors":"Joffrey Drigny, Anaëlle Calmès, Grégoire Prum","doi":"10.1002/pmrj.13330","DOIUrl":"https://doi.org/10.1002/pmrj.13330","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of microprocessor prosthetic knee use in early rehabilitation: A pilot randomized controlled trial.","authors":"Sara J Morgan, Janna L Friedly, Ian K Nelson, Rachael E Rosen, Andrew T Humbert, Brian J Hafner","doi":"10.1002/pmrj.13321","DOIUrl":"https://doi.org/10.1002/pmrj.13321","url":null,"abstract":"<p><strong>Background: </strong>Microprocessor-controlled prosthetic knees (MPKs) improve safety, stability, and mobility for people with transfemoral amputation. Despite these benefits, MPKs are often not used for people in early rehabilitation.</p><p><strong>Objective: </strong>To assess the feasibility of a study that compares MPKs and nonmicroprocessor knees (NMPKs) for people with recent transfemoral amputation and report on health outcomes after 3 months of use. Investigators hypothesized that MPK users would have better outcomes than NMPK users.</p><p><strong>Design: </strong>Pilot randomized controlled study.</p><p><strong>Setting: </strong>Institutional laboratory.</p><p><strong>Participants: </strong>Adults with recent unilateral transfemoral amputation, deemed ready for their first prosthesis, and weighed <125 kg. Eighteen participants enrolled; 15 completed the study.</p><p><strong>Interventions: </strong>Participants were randomized to use a MPK or NMPK in their first prosthesis.</p><p><strong>Main outcome measure(s): </strong>Feasibility outcomes included recruitment, retention, and missing data. Health outcome measures included performance-based and self-reported measures of mobility, participation, step activity, and falls.</p><p><strong>Results: </strong>Eighteen of 24 planned participants enrolled in the study. Fifteen participants received a study prosthesis and completed the 3-month trial (MPK: n = 9; NMPK: n = 6). Participants with an MPK had significantly higher Prosthetic Limb Users Survey of Mobility (p = .01, Hedges' g: 1.70), Activity-specific Balance Confidence (p = .01, Hedges' g: 1.75), and Return to Normal Living Index (p = .05, Hedges' g: 0.54) scores compared to patients with NMPK. No other outcomes significantly differed between groups; effect sizes (0.47-1.75) across mobility outcomes indicated better outcomes in the MPK group.</p><p><strong>Conclusions: </strong>Enrollment goals were limited by the COVID-19 pandemic, but all 15 participants who received a study prosthesis finished the 3-month pilot study. The MPK group generally had better 3-month outcomes than the NMPK group, but few statistically significant differences were found due to the small sample size and heterogeneity within groups. Results from this pilot study can inform and power future studies that compare MPKs and NMPKs in early rehabilitation.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of neuralgic amyotrophy presenting with multiple lower cranial neuropathies with delayed onset of symptoms.","authors":"Takashi Kasahara, Takeshi Kimachi, Mitsuhiko Kodama, Katsuhiro Mizuno","doi":"10.1002/pmrj.13334","DOIUrl":"https://doi.org/10.1002/pmrj.13334","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Academy News - February 2025 PM&R.","authors":"","doi":"10.1002/pmrj.13363","DOIUrl":"https://doi.org/10.1002/pmrj.13363","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":"17 2","pages":"240"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral neuropathy prevalence and effect on mobility 12 months after prosthesis prescription among individuals with dysvascular lower extremity amputation.","authors":"Daniel C Norvell, Elizabeth G Halsne, Alison W Henderson, Aaron P Turner, Wayne T Biggs, Joseph Webster, Joseph M Czerniecki, David C Morgenroth","doi":"10.1002/pmrj.13253","DOIUrl":"10.1002/pmrj.13253","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence of peripheral neuropathy (PN) and its effect on mobility in patients who were prescribed a lower limb prosthesis (LLP) after an incident dysvascular transtibial (TT) or transfemoral (TF) lower extremity amputation (LEA). We also sought to determine if the effect of PN on mobility was modified by amputation level or depression.</p><p><strong>Design: </strong>Participants were identified retrospectively through the Veterans Affairs (VA) Corporate Data Warehouse (CDW) from March 1, 2018, to November 30, 2020, then were contacted prospectively to obtain their self-reported mobility. Multiple logistic regression was used to control for potential confounders and identify potential effect modifiers.</p><p><strong>Setting: </strong>The VA CDW, the National Prosthetics Patient Database, participant mailings and phone calls.</p><p><strong>Participants: </strong>Three hundred fifty-seven individuals who underwent a TT or TF amputation due to diabetes and/or peripheral arterial disease and were fitted with a qualifying LLP.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcomes measures: </strong>The Locomotor Capabilities Index basic and advanced mobility subscale scores.</p><p><strong>Results: </strong>Two-hundred thirty seven participants (66%) had a diagnosis of PN prior to prosthesis prescription. The detrimental effect of PN on achieving basic and advanced mobility was significant after adjusting for potential confounding factors (adjusted odds ratio [aOR], 0.53; 95% confidence interval [CI], 0.30-0.94; p = .03 and aOR, 0.43; 95% CI, 0.24-0.77; p = .005, respectively). The detrimental effect of PN was more pronounced in patients with depression, especially for advanced mobility (aOR, 0.36; 95% CI, 0.14-0.95; p = .04) versus no depression (aOR, 0.53; 95% CI, 0.27-1.0; p = .07).</p><p><strong>Conclusions: </strong>PN is common in patients who have undergone an LEA due to diabetes and/or vascular disease and patients with this diagnosis should be carefully evaluated. Targeted rehabilitation programs to mitigate its potential detrimental effects on mobility are important and should specifically include mental health assessment and treatment.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"159-169"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142111225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomized, double-blind, placebo-controlled trial of DaxibotulinumtoxinA for Injection for the treatment of upper limb spasticity in adults after stroke or traumatic brain injury.","authors":"Atul T Patel, Michael C Munin, Ziyad Ayyoub, Gerard E Francisco, Rashid Kazerooni, Todd M Gross","doi":"10.1002/pmrj.13258","DOIUrl":"10.1002/pmrj.13258","url":null,"abstract":"<p><strong>Background: </strong>Intramuscular injection of botulinum toxin type A is a first-line pharmacotherapy for adults with upper limb spasticity (ULS). However, reemergence of symptoms within 12 weeks of treatment is common and longer-lasting treatments are needed.</p><p><strong>Objective: </strong>To evaluate the efficacy and safety of three doses of DaxibotulinumtoxinA for Injection (DAXI) for treatment of ULS in adults with stroke or traumatic brain injury.</p><p><strong>Intervention: </strong>Intramuscular injections of placebo (N = 24), DAXI 250 U (N = 22), DAXI 375 U (N = 19), or DAXI 500 U (N = 18) to the suprahypertonic muscle (SMG) and other muscle groups.</p><p><strong>Design: </strong>Randomized, double-blind, placebo-controlled study.</p><p><strong>Setting: </strong>Twenty-six study centers across the United States.</p><p><strong>Participants: </strong>Eighty-three adult patients with ULS were randomly assigned to each treatment group and followed for up to 36 weeks.</p><p><strong>Outcome measures: </strong>Co-primary endpoints were the Modified Ashworth Scale (MAS) score change from baseline in the designated SMG and Physician Global Impression of Change (PGIC) at Week 6.</p><p><strong>Results: </strong>The mean changes from baseline in MAS score for the designated SMG for placebo and the DAXI 250 U, 375 U, and 500 U groups were -0.6, -0.9, -0.9, and -1.8, respectively, at Week 4 and -0.8, -0.9, -1.0, and -1.5, respectively, at Week 6. Statistically significant improvement in MAS score compared with placebo was reported only for the 500 U dose (Week 4: p < .001; Week 6: p = .049). Significant improvements in PGIC ratings compared with placebo were reported for DAXI 375 U (p = .015) and DAXI 500 U (p = .009) at Week 4 but not for any DAXI doses at Week 6. All DAXI doses were well tolerated with no trend toward more adverse events with increased dose.</p><p><strong>Conclusion: </strong>Results from this Phase 2 study indicate that DAXI 500 U is effective and well tolerated for treatment of adults with ULS.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"126-136"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of early rehabilitation interventions in patients with traumatic brain injury using a large database.","authors":"Shota Hayashi, Tomohiko Kamo, Ryo Momosaki","doi":"10.1002/pmrj.13243","DOIUrl":"10.1002/pmrj.13243","url":null,"abstract":"<p><strong>Background: </strong>Rehabilitation is important for patients with moderate-to-severe traumatic brain injury (TBI). However, the timing of early rehabilitation initiation is ambiguous, and its safety and effectiveness are unknown.</p><p><strong>Objective: </strong>To examine the effectiveness and safety of early rehabilitation in patients with moderate-to-severe TBI using propensity score analysis and a large database.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>A large medical database (JMDC database) of tertiary care facilities was used to compare outcomes of early and delayed rehabilitation.</p><p><strong>Patients: </strong>Patients aged between 20 and 90 years who were diagnosed with TBI were admitted to acute care hospitals. Inclusion criteria were patients undergoing rehabilitation within 7 days of admission with a Glasgow Coma Scale score of 3 to 12 on admission. This study included 3074 patients with moderate-to-severe TBI.</p><p><strong>Interventions: </strong>Patients were classified into an early rehabilitation group (within 2 days of admission) or a delayed rehabilitation group (3 to 7 days postadmission), depending on when rehabilitation started after TBI. Rehabilitation was defined as any type or intensity of intervention provided by a physical, occupational, and/or speech/language therapist. Interventions were not controlled.</p><p><strong>Main outcome measure(s): </strong>The primary outcome was Barthel Index (BI) efficiency (BI gain/length of stay). Secondary outcomes included BI gain (discharge BI - admission BI), incidence of aspiration pneumonia complications during hospitalization, discharge to home, mortality, and length of stay.</p><p><strong>Results: </strong>After applying inverse probability weighting with propensity scores, the total was 6152 patients. 3074 (50.0%) patients received early rehabilitation. The early rehabilitation group showed no difference in inpatient mortality (p = .438), improved BI efficiency (β = 0.86, p < .001), and shorter length of stay (β = -5.00, p = .018).</p><p><strong>Conclusions: </strong>Early rehabilitation in patients with moderate-to-severe TBI is associated with more efficient functional improvement and reduced hospital stays without an increase in inpatient mortality.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"170-177"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}